SURGICAL ASSISTANCE DEVICE AND SURGERY SUPPORT SYSTEM
An object is to provide a surgical assistance device and a surgery support system that can ensure a sufficient field of view during an arthroscopic surgery. The object can be achieved by a surgical assistance device for capturing an image inside a body cavity. The surgical assistance device includes: N image capturing units; holding parts, each of the holding parts holding each of the image capturing units; and a base member, and N is an integer that is greater than or equal to three. When N virtual lines each passing through each of the holding parts holding the N image capturing units are defined as reference lines for arrangement when the N virtual lines are substantially parallel to each other and substantially perpendicular to a virtual plane formed by the base member or the holding parts, each of the image capturing units is arranged so as to be oriented to outside at an angle that is greater than or equal to 0 degree and less than or equal to 10 degrees relative to each of the reference lines passing through each of the holding parts.
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The disclosure in the present application relates to a surgical assistance device and a surgery support system.
BACKGROUND ARTIn the field of surgical operations, arthroscopic surgeries such as laparoscopic surgeries or thoracoscopic surgeries have rapidly become prevalent in place of surgeries under direct view such as conventional laparotomy surgeries or thoracotomy serveries. The arthroscopic surgeries have various advantages in terms of esthetic outcome, low invasiveness, or the like.
In arthroscopic surgeries, unlike laparotomy surgeries or thoracotomy serveries, the operator is unable to directly view the affected part. Thus, there is a known example in which a plurality of trocars having cameras are inserted in the body, images obtained from the cameras are synthesized based on camera positions estimated by position sensors, and the operator operates a surgical instrument such as a forceps while viewing a monitor displaying the synthesized image (see Patent Literature 1).
CITATION LIST Patent Literature
- Patent Literature 1: Japanese Patent No. 5975504
Even with today's advanced medical technologies, deaths due to intraoperative vascular injuries have been reported. According to a questionnaire survey by the Japanese Society for Endoscopic Surgery, many surgeons cite “insufficient field of view” as one of the causes of vascular injuries. It is thus desired to ensure a wide field of view required for proceeding a safe surgery (hereafter, which may be simply referred to as “field of view”) in the arthroscopic surgery. In the art disclosed in Patent Literature 1, however, each camera is arranged at the tip of the trocar inserted in the body. Therefore, although it is possible to capture an image of a part of the body inside the camera, it is not possible to capture an image of a part of the body outside the camera, and thus, there is a problem of inability of panoramically viewing the field of view.
Further, in the art disclosed in Patent Literature 1, a plurality of trocars each having a camera arranged at the tip are inserted in the body. That is, the positional relationship among the cameras arranged to the trocars varies for each surgery or during the surgery. Thus, in the art disclosed in Patent Literature 1, the trocars have position markers, and it is required to detect the position markers by position sensors and synthesize images obtained based on estimated positions of the cameras. Thus, there is a problem of complex image synthesis.
The disclosure in the present application has been made to solve the above problems and newly found through an intensive study that, by arranging a surgical assistance device having three or more image capturing units arranged to a base member at an incision site during a surgery, it is possible to ensure a sufficient field of view without requiring position markers.
That is, an object of the disclosure in the present application is to provide a surgical assistance device and a surgery support system that can ensure a sufficient field of view during an arthroscopic surgery.
Solution to ProblemThe disclosure in the present application relates to a surgical assistance device and a surgery support system illustrated below.
(1) A surgical assistance device for capturing an image inside a body cavity, the surgical assistance device comprising:
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- N image capturing units;
- holding parts, each of the holding parts holding each of the image capturing units; and
- a base member,
- wherein N is an integer that is greater than or equal to three, and
- wherein when N virtual lines each passing through each of the holding parts holding the N image capturing units are defined as reference lines for arrangement when the N virtual lines are
- substantially parallel to each other, and
- substantially perpendicular to a virtual plane formed by the base member or the holding parts,
- each of the image capturing units is arranged so as to be oriented to outside at an angle that is greater than or equal to 0 degree and less than or equal to 10 degrees relative to each of the reference lines passing through each of the holding parts.
(2) The surgical assistance device according to (1) above, wherein the holding parts are formed as separate components from the base member.
(3) The surgical assistance device according to (1) or (2) above, wherein the angle of at least one of the N image capturing units is variable.
(4) The surgical assistance device according to (2) or (3) above, wherein the holding parts formed as the separate components from the base member are formed rotatably relative to the base member.
(5) The surgical assistance device according to any one of (1) to (4) above, wherein the base member is formed of a flexible material.
(6) The surgical assistance device according to any one of (1) to (5) above, wherein each of the image capturing units is arranged so as to be oriented to outside of the base member at an angle that is greater than or equal to 5 degrees and less than or equal to 10 degrees relative to each of the reference lines passing through each of the holding parts.
(7) A surgery support system comprising: - the surgical assistance device according to any one of (1) to (6) above; and
- an image processing unit that synthesizes images obtained from the image capturing units.
(8) The surgery support system according to (7) above further comprising a display unit that displays an image processed by the image processing unit.
(9) A program used for the surgery support system according to (8) above.
(10) The program according to (9) above, wherein when any of the image capturing units captures a surgical instrument during a surgery, the program performs image processing so that the surgical instrument is not displayed on the display unit based on - an image captured by another of the image capturing units, or
- an image inside a body cavity captured before image capturing of the surgical instrument is detected.
The surgical assistance device and the surgery support system disclosed in the present application can be suitably used for arthroscopic surgeries.
FIG. 18D1 is a diagram illustrating the arrangement of a surgical assistance device produced in Comparative example 1 to a mock human body. FIG. 18D2 is a photograph substitute for a drawing, which is a synthesized image obtained in Comparative example 1.
A surgical assistance device and a surgery support system disclosed in the present application will be described below in detail. Note that the position, size, range, or the like of each component illustrated in the drawings may not represent the actual position, size, range, or the like for easier understanding. Thus, the disclosure of the present application is not necessarily limited to the position, the size, the range, or the like disclosed in the drawings.
Further, in the present specification, the following interpretation will be applied for expression of numerical values, abbreviations, or the like.
-
- (1) A numerical range represented by using “to” means a range including numerical values written before and after “to” as the lower limit value and the upper limit value.
- (2) A numerical value, a numerical range, and a qualitative expression (for example, expression of “identical”, “the same”, or the like) indicate a numerical value, a numerical range, and a nature including an error generally tolerated in the field of the art of interest.
- (3) When “substantially XX” is referred to, this includes a state recognized as approximately XX in addition to the exact XX. For example, when substantially parallel is referred to, this means that a slight shift is tolerated in addition to a state of being exactly parallel.
A surgical assistance device 1a according to an embodiment will be described with reference to
The surgical assistance device 1a includes image capturing units 2, holding parts 3 that hold the image capturing units 2, and a base member 4. In the example illustrated in
Each image capturing unit 2 is not particularly limited as long as it can capture an image inside a body cavity. For example, a CCD image sensor, a CMOS image sensor, Foveon X3, an organic thin-film image capturing element, or the like may be employed. Note that the image capturing range of the image capturing unit 2 is not particularly limited. While it is conceivable to use a wide-angle camera to capture an image inside a body cavity by a single image capturing unit 2, in such a case, the edge of an image may be blurred. Further, there may be a part unable to be captured due to a surgical instrument, an organ, or the like (a part hidden behind the same). In contrast, since the surgical assistance device 1a is equipped with three or more image capturing units 2, it is possible to ensure a sufficient field of view and reduce a hidden part even with use of the sensor or the like described above that are commonly, commercially available.
In the example illustrated in
The holding parts 3 are provided in the base member 4 for holding the image capturing units 2. Although each holding part 3 is formed so as to penetrate through the base member 4 in the example illustrated in
The angle of the image capturing unit 2 held by the holding part 3 will be described with reference to
First, each virtual line VL is defined as a reference line BL, for arrangement where virtual lines VL passing through the holding parts 3 are substantially parallel to each other and substantially perpendicular to the virtual plane VF formed by the base member 4 or the holding parts 3. Each of the image capturing units 2 is arranged so as to be oriented to outside of the base member 4 at an angle α that is greater than or equal to 0 degree and less than or equal to 10 degrees relative to the reference line BL passing through each of the holding parts 3.
The place through which the holding part 3 passes is not particularly limited as long as the virtual line VL passes through the holding part 3. If the virtual line VL satisfies the condition to be the reference line described above regardless of which holding part 3 the virtual line VL passes through, the angle relative to the image capturing unit 2 held by the holding part 3 can be defined.
Although the lower end side of the base member 4 is defined as the virtual plane VF in the example illustrated in
The image capturing unit 2 is held by the holding part 3 at the angle α that is greater than or equal to 0 degree and less than or equal to 10 degrees relative to the reference line BL passing through the holding part 3. Note that, in the example illustrated in
The angle α of the image capturing unit 2 relative to the reference line BL is set so that the image capturing unit 2 is oriented to outside of the base member 4 at the angle α that is greater than or equal to 0 degree and less than or equal to 10 degrees. As will be illustrated in Examples described later, the arrangement of the image capturing units 2 relative to ribs is adjusted, and thereby a sufficient field of view can be ensured even when the angle α is 0 degree. However, it is desirable that the surgical assistance device 1a can be used without taking into account of the arrangement of the image capturing unit 2 relative to the rib. In such a case, the angle α is desirably greater than 0 degree and can be suitably adjusted to be, for example, 0.5 degrees or greater, 1 degree or greater, 1.5 degrees or greater, 2 degrees or greater, 2.5 degrees or greater, 3 degrees or greater, 3.5 degrees or greater, 4 degrees or greater, 4.5 degrees or greater, 5 degrees or greater, or the like. In contrast, if the angle α of the image capturing unit 2 is excessively large, in other words, if the image capturing unit 2 is excessively oriented to outside of the base member 4, it will be difficult to obtain an image directed to the center of the base member 4. Therefore, the angle α can be suitably adjusted to be 12 degrees or less, 11.5 degrees or less, 11 degrees or less, 10.5 degrees or less, 10 degrees or less, 9.5 degrees or less, 9 degrees or less, 8.5 degrees or less, 8 degrees or less, or the like. Note that angles α of N image capturing units 2 may be the same or may be different, respectively.
The direction of the angle α of the image capturing unit 2 relative to the reference line BL will be described with reference to
Next, positions at which N image capturing units 2 are arranged will be described with reference to
The base member 4 is not particularly limited in its material or the like as long as the holding parts 3 can be formed therein to hold the image capturing units 2. For example, an inflexible material that does not cause a change in the shape of the base member 4 may be used. Alternatively, the base member 4 may be formed of a flexible material that causes a change in the shape when the surgical assistance device 1a is inserted in an incised part. For example, a known medical material can be used for the inflexible material and the flexible material. The inflexible material may be, for example, a medical plastic such as polysulfone, polyvinylidene fluoride, polycarbonate, polypropylene, or the like; or a metal such as titanium, stainless, or the like. Further, the flexible material may be a medical plastic such as silicon, polyvinyl chloride, or the like.
When the surgical assistance device 1a is used for a thoracoscopic surgery, the surgical assistance device 1a is arranged between ribs. Thus, as illustrated in
The surgical assistance device 1a according to the embodiment can be produced by using a 3D printer or the like to form the base member 4 equipped with the holding parts 3 and then inserting the image capturing units 2 in the holding parts 3.
Once a surgery support system is constructed with the surgical assistance device 1a according to the embodiment, it is possible to obtain an image panoramically viewing inside of a body cavity from a position where the surgical assistance device 1a is arranged. Therefore, a field of view required in a surgery can be ensured. Further, in operating a surgical instrument or the like, even when there is a portion where one image capturing unit is unable to capture an image due to the surgical instrument, it is possible to capture an image inside a body cavity by using another image capturing unit. Furthermore, because the relative positional relationship among the image capturing units 2 does not change, it is possible to easily synthesize an image without requiring use of position sensors or the like.
Modified Example to Embodiment of Surgical Assistance DeviceNext, modified examples to the embodiment of the surgical assistance device 1a will be described. The surgical assistance device 1a is the same as the surgical assistance device according to the modified examples except for those described below. Accordingly, for the modified examples, duplicated description for the features that have already been described in the embodiment of the surgical assistance device 1a will be omitted. It is thus apparent that, even though not explicitly described in the modified examples, the features that have already been described in the embodiment of the surgical assistance device 1a can be employed.
Modified Example 1 of Holding Part 3The same material as that for the base member 4 described above can be used for the holding part base member 3b, and the material forming the base member 4 and the material forming the holding part base member 3b are the same or may be different from each other. Further, the angle of the image capturing unit 2 held by the through hole 3c is the same as that of the surgical assistance device 1a. Further, although the through hole 3c is formed so as to penetrate the holding part base member 3b in the example illustrated in
Note that, in the example illustrated in
According to the surgical assistance device 1c equipped with the holding part 3a of modified example 2, in addition to the advantageous effects achieved by the surgical assistance device 1a, an advantageous effect of less pain for the patient is achieved because the abduction in flexion of ribs can be reduced.
Modified Example 3 of Holding Part 3In the example illustrated in
Note that the example illustrated in
According to the surgical assistance device 1d equipped with the holding part 3a of modified example 3, in addition to the advantageous effects achieved in the surgical assistance device 1a, an advantageous effect of the variable angle of the image capturing unit 2 relative to the reference line in accordance with a patient size or a use situation is achieved.
Modified Example 1 of Base Member 4The ratio of the longer axis LA and the shorter axis SA of the ellipse is not particularly limited as long as it is within a range that can ensure a sufficient field of view. For example, LA/SA may be 2 or less, 1.9 or less, 1.8 or less, 1.7 or less, 1.6 or less, 1.5 or less, or the like. Note that the size of the ellipse is such that the shorter axis SA corresponds to the diameter of the surgical assistance device 1a. Further, the relationship between the image capturing unit 2 and the holding part 3 when the base member 4 is elliptical is the same as that in the surgical assistance device 1a according to the embodiment and its modified examples 1b to 1d except that the virtual center VC is the intersecting point of the longer axis LA and the shorter axis SA.
When used for a thoracoscopic surgery, the surgical assistance device 1 is required to be arranged between ribs. Thus, while the spacing between ribs can be expanded by using an instrument, the size of the surgical assistance device 1 depends on the spacing between the ribs. When the base member of the surgical assistance device 1 is substantially circular, the image capturing units are required to be arranged in the circular base member in the size described above. In contrast, in the example illustrated in
The surgical assistance devices 1a to 1e illustrated in
The surgery support system 10 according to the embodiment will be described with reference to
As the surgical assistance device 1, any of the surgical assistance device and its modified examples (1a to 1e) illustrated in
The display unit 12 is not particularly limited as long as it can display an image processed by the image processing unit 11, and a known monitor such as a liquid crystal monitor, an organic EL monitor, or the like can be used.
Embodiment of ProgramThe image processing unit 11 stores a program that can synthesize images obtained from N image capturing units 2. The program is not particularly limited as long as it can synthesize images obtained from N image capturing units 2 and can be used as a program of the surgery support system.
The program may perform image processing using the feature of the surgical assistance device 1 disclosed in the present application. For example, since the surgical assistance device 1 disclosed in the present application is equipped with N image capturing units 2, even when one image capturing unit 2 is unable to capture an image of a part inside a body cavity due to a surgical instrument, another image capturing unit 2 may be able to capture an image inside the body cavity. In such a case, the program may perform image processing so that, when some of the image capturing unit 2 captures an image of a surgical instrument, an image captured by another image capturing unit 2 can be displayed. Image capturing of a surgical instrument (detection of a surgical instrument) can be detected in accordance with a change in the color in a captured image, a sudden motion, or the like due to the surgical instrument.
Further, there may be a case where regions that can be captured by different image capturing units 2 do not overlap, in other words, there may be a case where an image of a surgical instrument is captured in a region captured by a single image capturing unit 2. In such a case, the program can perform image processing by using an image inside the body cavity captured before image capturing of the surgical instrument is detected. For example, images inside the body cavity may be captured and stored in advance before a surgery is started or images in the past several seconds may be stored in advance, and image processing can be performed so that the surgical instrument is not visible based on the stored images.
Further, the program may perform image processing so as to be able to display a VR-like image such as displaying information required for a surgery or the like in combination, where necessary, instead of displaying the image captured by the image capturing unit 2 as it stands. When these programs are provided as separate components, the user-friendliness of the surgery support system is improved.
Note that the disclosure in the present application is not limited to the embodiments described above. Any combination of respective embodiments described above, modification of some component of each embodiment, or omission of some component is possible within the scope of the technical concept disclosed in the present application. Furthermore, some component may be added to each embodiment described above. For example, a function of changing the frequency of a light source irradiating inside of a body cavity to make the depth inside the body cavity known may be added.
Although Examples will be provided below and the embodiment disclosed in the present application will be specifically described, the Examples are merely for illustration of the embodiment, which are intended neither to limit the scope of the invention disclosed in the present application nor to express limitation of the same.
EXAMPLES Production of Surgical Assistance Device Example 1As the material forming the holding parts 3a and the base member 4, Agilista-3100 (by KEYENCE CORPORATION) was used, and a 3D printer was used to mold the holding parts 3a and the base member 4 in one piece. Three holding parts 3a were formed at equal intervals. The base member 4 was substantially cylindrical, and the diameter of the base member 4 was about 60 mm. Further, the length from the outer circumference of the base member 4 to the end of the holding part 3a (the length of a protruding portion from the base member 4) was about 17 mm. Next, MD-3110VL-NU-158 (Weld Vision Limited Liability Company) was used as the image capturing units 2 and inserted in the holding parts 3a to produce the surgical assistance device 1.
The image capturing units of each surgical assistance device produced in Example 1 was connected to the image processing unit that synthesizes images by using an algorithm developed by the inventor (the function was expanded based on Open Source Computer Vision Library (OpenCV). Next, the image processing unit was connected to the monitor to produce the surgery support system.
Observation Inside Body Cavity Using Mock Human BodyNext, the surgical assistance device of the surgery support system produced in Example 2 was inserted between ribs of a mock human body.
The angle of the image capturing unit 2 relative to the reference line was:
-
- 0 degree (Example 3) in images indicated in
FIGS. 13 ; - 1 degree (Example 4) in images indicated in
FIG. 14 ; - 3 degrees (Example 5) in images indicated in
FIG. 15 ; - 5 degrees (Example 6) in images indicated in
FIG. 16 ; and - 10 degrees (Example 7) in images indicated in
FIG. 17 .
- 0 degree (Example 3) in images indicated in
Although a partial loss was found in the upper part of the mock lung in the synthesized image illustrated in
The synthesized images illustrated in
In the synthesized images illustrated in
In contrast, in the synthesized image illustrated in
FIG. 18D1 illustrates a surgical assistance device produced in Comparative example 1 and the arrangement thereof relative to a mock human body. In the surgical assistance device of Comparative example 1, the number of holding parts 3a holding image capturing units was two, which were arranged such that the line connecting two holding parts 3a passed through the substantial center of the base member 4. The angle of the image capturing unit relative to the reference line was 1 degree, and the two holding parts 3a were arranged in contact with ribs. FIG. 18D2 is a synthesized image obtained in Comparative example 1. Further, for comparison, the synthesized image for the arrangement A of Example 4 (
-
- the base member 4 was elliptical having the longer axis of 6 cm and the shorter axis of 3 cm;
- one of the holding parts 3a was arranged at the intersecting point of the shorter axis of the ellipse and the base member, and the remaining two are arranged at equal intervals so as to form an angle of 120 degrees with respect to the ellipse center, respectively; and
- the angle of each image capturing unit is 5 degrees, and each image capturing unit is oriented to outside from the ellipse center. Next, the surgery support system was produced in the same procedure as that in Example 2.
The right side in
The surgical assistance device and the surgery support system disclosed in the present application can ensure a wide field of view during an arthroscopic surgery, which are therefore useful for manufacturing industries for medical devices.
LIST OF REFERENCES
-
- 1, 1a to 1e surgical assistance device
- 2 image capturing unit
- 3, 3a holding part
- 3b holding part base member
- 3c through hole
- 3d spherical protruding part
- 3e spherical recessed part
- 3f stopper
- 31 upper end of a holding part
- 32 lower end of a holding part
- 4 base member
- 10 surgery support system
- 11 image processing unit
- 12 display unit
- BL reference line
- CL center line of an image capturing unit
- dα direction of angle α
- IL image capturing range
- LA longer axis
- SA shorter axis
- VC virtual center
- VF virtual plane
- VL virtual line
Claims
1. A surgical assistance device for capturing an image inside a body cavity, the surgical assistance device comprising:
- N image capturing units;
- holding parts, each of the holding parts holding each of the image capturing units; and
- a base member,
- wherein N is an integer that is greater than or equal to three, and
- wherein when N virtual lines each passing through each of the holding parts holding the N image capturing units are defined as reference lines for arrangement when the N virtual lines are
- substantially parallel to each other, and
- substantially perpendicular to a virtual plane formed by the base member or the holding parts,
- each of the image capturing units is arranged so as to be oriented to outside at an angle that is greater than or equal to 0 degree and less than or equal to 10 degrees relative to each of the reference lines passing through each of the holding parts.
2. The surgical assistance device according to claim 1, wherein the holding parts are formed as separate components from the base member.
3. The surgical assistance device according to claim 1, wherein the angle of at least one of the N image capturing units is variable.
4. The surgical assistance device according to claim 2, wherein the holding parts formed as the separate components from the base member are formed rotatably relative to the base member.
5. The surgical assistance device according to claim 1, wherein the base member is formed of a flexible material.
6. The surgical assistance device according to claim 1, wherein each of the image capturing units is arranged so as to be oriented to outside of the base member at an angle that is greater than or equal to 5 degrees and less than or equal to 10 degrees relative to each of the reference lines passing through each of the holding parts.
7. A surgery support system comprising:
- the surgical assistance device according to claim 1; and
- an image processing unit that synthesizes images obtained from the image capturing units.
8. The surgery support system according to claim 7 further comprising a display unit that displays an image processed by the image processing unit.
9. A program used for the surgery support system according to claim 8.
10. The program according to claim 9, wherein when any of the image capturing units captures a surgical instrument during a surgery, the program performs image processing so that the surgical instrument is not displayed on the display unit based on
- an image captured by another of the image capturing units, or
- an image inside a body cavity captured before image capturing of the surgical instrument is detected.
11. The surgical assistance device according to claim 1, wherein the holding parts are formed as through holes penetrating the base member.
12. The surgical assistance device according to claim 1, wherein the holding parts are formed as cutouts in an outer circumferential face of the base member.
13. The surgical assistance device according to claim 11, wherein the N image capturing units are arranged at substantially equal intervals in the base member.
14. The surgical assistance device according to claim 11, wherein the base member is formed in a substantially elliptical shape.
15. The surgical assistance device according to claim 12, wherein the N image capturing units are arranged at substantially equal intervals in the base member.
16. The surgical assistance device according to claim 12, wherein the base member is formed in a substantially elliptical shape.
17. The surgical assistance device according to claim 13, wherein the base member is formed in a substantially elliptical shape.
18. The surgical assistance device according to claim 11, wherein the angle of at least one of the N image capturing units is variable.
19. The surgical assistance device according to claim 12, wherein the angle of at least one of the N image capturing units is variable.
20. The surgical assistance device according to claim 14, wherein the angle of at least one of the N image capturing units is variable.
Type: Application
Filed: Oct 25, 2021
Publication Date: Jan 18, 2024
Applicant: Nagoya Denki Educational Foundation (Nagoya-shi, Aichi)
Inventors: Shota NAKAMURA (Nagoya-shi, Aichi), Toyofumi YOSHIKAWA (Nagoya-shi, Aichi), Takayuki KITASAKA (Toyota-shi, Aichi), Yuichiro HAYASHI (Nagoya-shi, Aichi), Kensaku MORI (Nagoya-shi, Aichi)
Application Number: 18/245,713